Anorectal Patients Research Articles

Application of ALCOCK Tube Ultrasound-guided Internal Pudendal Nerve Block in Postoperative Anal Analgesia

Background: While surgery is the most effective treatment for anorectal diseases, traditional anesthesia methods are increasingly regarded not suitable for the clinical needs of anorectal patients. Although pudendal nerve block can play a good analgesic role in the anal region, the traditional pudendal nerve block is performed under blind probing, which is inaccurate in positioning, has poor anesthesia effect, and causes many complications. Objectives: At present, ultrasound-guided pudendal nerve block for analgesia has emerged in clinical practice. Therefore, the present study aimed to investigate the analgesic effect of ALCOCK tube ultrasound-guided internal pudendal nerve block in anal surgery. Methods: A prospective study was conducted. A total of 134 patients who underwent anal surgery in Hangzhou Lin'an District First People's Hospital from May, 2021 to July, 2022 were divided into three categories according to mixed hemorrhoids, anal fistula, and anal fissure and randomly divided into control and experimental groups. The two groups were treated with corresponding surgical treatment, and the experimental group was treated with bilateral pudendal nerve block under the guidance of ALCOCK tube ultrasound at the end of the operation. The operation time, blood loss, initial postoperative pain time, and visual analogue scale, postoperative pain score at each time point, incidence of complications, and patient satisfaction were recorded and analyzed. Results: The operation time of the experimental group was significantly longer than that of the control group, the bleeding volume of anal fistula in the experimental group was more than the control group, the first pain time of anal fistula in the experimental group was higher than that of the control group. The first pain score of anal fistula in the experimental group was lower than that of the control group. Follow-up showed that the pain scores of anal fistula and anal fissure groups were inconsistent 48 h after surgery. The total incidence of adverse reactions was lower, and the patient satisfaction was higher in the experimental group than in the control group. Conclusion: The application of internal pudendal nerve block under the guidance of ALCOCK tube ultrasound in anal surgery has a good analgesic effect and high patient satisfaction, which is worthy of promotion.

Epidemiological Comparison of Anorectal Malformation With Other Gastrointestinal Abnormalities in Patients in the Pediatric Ward.

BackgroundAnorectal malformations are congenital defects wherein there is defective development of the anus and rectum. For babies born with congenital anorectal malformations, prompt treatment is crucial which requires detection of the anomalies at the earliest. This study aimed to determine the epidemiology ofanorectal malformations in the Pediatric Unit of a tertiary care hospital in Pakistan over a period of 19 months.MethodologyAn analytical cross-sectional study was conducted retrospectively from January 2020 to September 2021 using a non-randomized consecutive sampling technique. Patients aged less than eight years were included, whereas burnt, torn, and incomplete records from the Hospital Management Information System (HMIS) were excluded. SPSS version 26 (IBM Corp., Armonk, NY, USA) was used for data entry and analysis. Binomial and multinomial logistic regression were applied for analyzing the association between explanatory and dependent variables.ResultsOf the 1,108 patients, 72 (6.5%) patients had anorectal malformations. Gastrointestinal diseases made up about 64.3% of all diseases. Among gastrointestinal causes, the prevalence of anorectal malformation was up to 10.1%. The mortality of anorectal malformation patients was low (2.85%) compared to mortalities due to other gastrointestinal abnormalities (8.25%). Anorectal malformation had significantly lower odds of mortality (adjusted odds ratio = 0.19, p < 0.05) compared to other gastrointestinal abnormalities.ConclusionsThis study has provided data about the prevalence of anorectal malformation and its mortality which were calculated as 6.5% and 2.58%, respectively. Female gender, neonates, and delayed presentation were seen to have higher mortality, highlighting the need to screen all neonates pre- and post-natally to avoid any misdiagnosis.

Saddle block anesthetic technique for benign outpatient anorectal surgery

BackgroundCurrent American Society of Colorectal Surgery Clinical Practice Guidelines for Ambulatory Anorectal Surgery endorse use of monitored anesthesia care, general anesthesia, or spinal anesthesia based on physician and patient preference. Although several studies support the use of monitored anesthesia care over general anesthesia, the literature regarding spinal anesthesia is limited and heterogenous due to small sample sizes and disparate spinal anesthesia techniques. Saddle block anesthesia is a form of spinal anesthesia that localizes to the lowermost sacral spinal segments allowing for preservation of lower extremity motor function and faster recovery. We accrued one of the largest reported cohort of anorectal procedures using saddle block anesthesia, as such, we sought to evaluate our institutional 12-year experience. MethodsPatients who underwent a benign anorectal procedure at our outpatient surgery center between July 2008−2020 were retrospectively reviewed. Demographics, surgical factors, perioperative times, and adverse events were collected from the electronic medical records. Saddle block anesthesia was generally performed in the preoperative area using a spinal needle (25–27 gauge) and a single injection technique of a 1:1 ratio local anesthetic mixed with 10% dextrose solution. Between 2.5–5 mg of hyperbaric anesthetic was injected intrathecally in the sitting position and the patient remained upright for 3–10 minutes. This technique of saddle block anesthesia provides analgesia for approximately 1–3 hours. ResultsIn the study, 859 saddle block anesthesia patients were identified, with a mean age of 44.6 years and American Society of Anesthesia score of 1.9; 609 (70.9%) were male. Surgical indications included lesion removal (27.1%), anal fistula (25.8%), hemorrhoidectomy (24.7%), pilonidal disease (6.3%), anal fissure (5.8%), and a combination of prior (10.2%). Prone jackknife positioning was used in 91.6% of procedures. Saddle block anesthesia most often was performed with bupivacaine (48.9%) or ropivacaine (41.7%). The median procedural saddle block anesthesia time was 11 minutes, surgery time was 17 minutes, anesthesia time was 42 minutes, and recovery time was 91 minutes. Patients spent a median of 3 hours and 53 minutes in the facility. Adverse events included urinary retention (1.9%), conversion to general anesthesia (1.8%), spinal headache (1.5%), hemodynamic instability (0.9%), and injection site reaction (0.3%). ConclusionDemonstrated using the largest known cohort of anorectal patients with saddle block anesthesia, saddle block anesthesia provides an effective method of analgesia to avoid general anesthesia with a low rate of adverse events.

DIFFERENTIAL DIAGNOSIS OF BLEEDING PER RECTUM AND AYURVEDIC STYPTIC MEASURES: A REVIEW

A greater part of the population has experienced rectal bleeding at any stage of their life span. Bleeding per rectum is the commonest but alarming symptom of all the anorectal complaints of the patients attending OPDs. Many of the general practitioners involved in rural areas, detain per rectal and proctoscopic examination of anorectal primary care patients, consequently, most of the serious illnesses may forego undiagnosed and could become life-threatening and economically overburden the patient. Differential diagnosis plays a key role in treating effectively. Ayurvedic literature has accredited several diseases with symptoms of bleeding per rectum. In most of the pittaja and raktaja variety of pakvashayagata (related to the colon) and gudagata rogas (related to anus &amp; rectum), bleeding per rectum is the commonest symptom. The literature has given the number of etiological factors and many ailments causing bleeding per rectum such as age, habitat, food habits, occupation, and habits. Detailed history regarding these and nature of bleeding, amount of bleeding, colour etc. may certainly help to differentiate the diseases. This article highlights disease wise features and nature of bleeding, recommended investigations and colonoscopic examination which will differentiate and confirm the diagnosis. And also lists out several Ayurvedic styptic medicines which facilitate the cessation of bleeding when used judiciously according to dosha and vyadhi avastha.

Role of urodynamics in male patients of high-anorectal malformations: a prospective study.

Association of spinal or vertebral anomalies and the iatrogenic denervation during surgical correction of anorectal malformation patients especially in boys can lead to neurogenic bladder inthese subset of patients. The paucity of literature with regard to urodynamic studies focusing exclusively in male children with high-anorectal malformations (HARM) lead us to analyze the urodynamic changes. The objective was to study urodynamic profile in male patients who have undergone surgery for anorectal malformation. Male high-anorectal malformation patients who had completed all the stages of repair were prospective studied. Following the basic work up, all patients based on the urodynamics were categorized into 2 groups as safe or unsafe bladders. Unsafe bladder was defined as detrusor pressure > 40cm (high detrusor pressure) or pressure variability of 15cm of water (detrusor overactivity) or significant post-void residue. MRI was limited to patients with only abnormal urodynamics to rule out spinal causes of neurogenic bladder and due to financial constraints, it could not be offered to all patients. 41 HARM meet the exclusion criteria. All patients were asymptomatic with none having history of urinary tract infections. Ultrasound showed bladder wall thickening in 31.7% patients. UDS revealed reduction in bladder capacity and compliance was noted in 31.7% and 30% patients, respectively. Elevated detrusor pressures (> 40cm of water) were noted in 10% (4/41), detrusor overactivity with concomitant elevated detrusor pressures in 19.5% (8/41) and normal UDS in 70% (29/41). 13 patients (31.7%) had abnormal cystometric parameters with 12(30%) having unsafe bladders. MRI confirmed sacral agenesis in 1 patient with unsafe bladder. Urodynamics can demonstrate occult neurovesical dysfunction in patients with HARM. This would help in early renal protective therapy and prevent the burden of long-term sequelae of neurovesical dysfunction in HARM patients.

A Randomized Controlled Trial Examining the Impact of an Anorectal Surgery Multimodal Enhanced Recovery Program on Opioid Use.

Anorectal cases may be a common gateway to the opioid epidemic. Opioid reduction is inherent in enhanced recovery after surgery (ERAS) protocols, but little work has evaluated ERAS in these cases. To determine if ERAS could reduce postoperative opioid utilization in ambulatory anorectal surgery without sacrificing patient pain or satisfaction. A randomized controlled trial assigned ambulatory anorectal patients to ERAS (experimental) or routine care (surgeon's choice) for pain management (control) over 30-days postoperatively. Primary outcome was overall days of opioid use. Secondary outcomes included pain and satisfaction scores over multiple time points and new persistent opioid use. The Visual Analog Scale, Functional Pain Scale, and EQ-5D-3L measured patient-reported pain and satisfaction. Univariate analysis compared outcomes overall and at individual time points. Two-way mixed ANOVA evaluated pain and satisfaction measures between groups and over time. Thirty-two patients were randomized into each arm (64 total). The control group consumed significantly more opioids after discharge (median 121.3MME vs 23.5MME, P < 0.001). Significantly more control patients requested additional narcotics (P = 0.004), made unplanned calls (P = 0.009), and had unplanned clinic visits (P = 0.003). The control group had significantly more days on opioids (mean 14.4 vs 2.2, P < 0.001). Three control patients (9.4%) versus no experimental patients had new persistent opioid use. The mean global health, EQ5D-3L, Visual Analog Scale, and Functional Pain scores were comparable between groups over time. An ERAS protocol in ambulatory anorectal surgery is feasible, and resulted in reduced opioid use, and healthcare utilization, with no difference in pain or patient satisfaction. This challenges the paradigm that extended opioids are needed for effective postoperative pain management.

Multicentre, deep learning, synthetic-CT generation for ano-rectal MR-only radiotherapy treatment planning

Background and purposeComprehensive dosimetric analysis is required prior to the clinical implementation of pelvic MR-only sites, other than prostate, due to the limited number of site specific synthetic-CT (sCT) dosimetric assessments in the literature. This study aims to provide a comprehensive assessment of a deep learning-based, conditional generative adversarial network (cGAN) model for a large ano-rectal cancer cohort. The following challenges were investigated; T2-SPACE MR sequences, patient data from multiple centres and the impact of sex and cancer site on sCT quality. MethodRT treatment position CT and T2-SPACE MR scans, from two centres, were collected for 90 ano-rectal patients. A cGAN model trained using a focal loss function, was trained and tested on 46 and 44 CT-MR ano-rectal datasets, paired using deformable registration, respectively. VMAT plans were created on CT and recalculated on sCT. Dose differences and gamma indices assessed sCT dosimetric accuracy. A linear mixed effect (LME) model assessed the impact of centre, sex and cancer site. ResultsA mean PTV D95% dose difference of 0.1% (range: −0.5% to 0.7%) was found between CT and sCT. All gamma index (1%/1 mm threshold) measurements were >99.0%. The LME model found the impact of modality, cancer site, sex and centre was clinically insignificant (effect ranges: −0.4% and 0.3%). The mean dose difference for all OAR constraints was 0.1%. ConclusionFocal loss cGAN models using T2-SPACE MR sequences from multiple centres can produce generalisable, dosimetrically accurate sCTs for ano-rectal cancers.

MR defecography in ano-rectal dysfunction: a clinical-radiological correlation study

BackgroundThe aim of this work is to assess the diagnostic accuracy of MR defecography in ano-rectal dysfunction [ARD] for proper treatment planning.ResultsMR defecography was done to 30 patients with ARD for detection of its functional and structural causes. Increased perineal descent was detected in 70% of cases, rectocele in 46.7%, rectal intussusception in 40%, cystocele in 26.7%, uterine prolapse in 27.7%, enterocele in 13.3%, and paradoxical puborectalis contraction in 30%.ConclusionMR defecography is an essential diagnostic tool for optimum management of ano-rectal dysfunction patients.

Accuracy of Lateral Invertogram in diagnosing and classifying anorectal malformations

Background: The initial management of a new born baby with anorectal malformation could be made only after an accurate determination of the level of the anomaly. Objective: To determine the accuracy of lateral invertogram in diagnosing and classifying anorectal anomalies. Methods: This was a retrospective study carried out between January 2003 and December 2013. The accuracy, sensitivity, and specificity of lateral invertogram in diagnosing and classifying anorectal malformations in the cases studied were determined. Results: A total of 62 children with anorectal malformations patients were seen during the study period. The age range was 4 hours to 6 years. A total of 50 (80.6%) had lateral invertogram while only 39 films of lateral invertogram were available for analysis. A total of 22 patients had high anomalies while 12 patients had low anomalies. The accuracy of lateral invertogram in identifying anorectal anomaly was 100% and its ability to differentiate between high and low anomalies was 76.5%. The Sensitivity in identifying high anomalies was 59% while the specificity was 31.8%. The sensitivity in identifying low lying lesions was 66.5% while the specificity was 50%. Conclusion: The accuracy, sensitivity, and specificity of lateral invertogramin diagnosing and classifying anorectal malformations were found to be satisfactory in the present study.

The change over time in the postoperative bowel function in male anorectal malformation patients who underwent sacroperineal anorectoplasty and sacroabdominoperineal anorectoplasty.

Many kinds of operative procedures have been proposed for anorectal malformation (ARM) patients. At our institution, sacroperineal or sacroabdominoperineal anorectoplasty (SP-SAP) have been performed from 1984 to 2007. The aim of this study is clarify the change over the time in the postoperative bowel function in male ARM patients. Patient data were collected from 1984 to 2007. Fifty-two male patients with high- and intermediate-type ARM were enrolled. The patients' characteristics and bowel function were reviewed and analyzed retrospectively. The bowel function was evaluated according to the evacuation score (ES) of the Japan Society of ARM Study Group. The operative procedures were SP-SAP in 52 male patients. The total ES improved chronologically and significantly until 11years of age. Regarding the clinical stratification of the ES, the ratio of "excellent" and "good" results was over 91.9% at 11years of age. A satisfactory bowel movement score was achieved by 9years of age. The constipation, incontinence and soiling scores improved slowly but continuously until 11years of age. The ES showed continuous improvement after a definitive operation. An understanding of the characteristics of improvement is very important in managing the postoperative bowel function in ARM patients.

Ectopic ureters in anorectal malformations.

The literature about ectopic ureters in anorectal malformations is limited. Repair of an anorectal malformation may require dissection near the normal or abnormal insertion of the ureters. Knowledge of the presence and location of ectopic ureters may prevent intraoperative injury. We aim to describe the incidence and location of ectopic ureters in patients with anorectal malformations and to characterize associated renal anomalies. This is an IRB-approved retrospective study of patients with anorectal malformations and ectopic ureters identified in our colorectal database. Of 2283 patients with anorectal malformation, 79 (3.5%) had ectopic ureter(s). Of those, 29% had bilateral ectopic ureters. Nearly all (87%) of bilateral ectopic ureters occurred in females. Ectopic ureters most commonly inserted into the bladder neck (33%), vagina (15%), or urethra (13%). Renal dysfunction was noted in a high proportion of patients. The majority (59%) of ectopic ureters were associated with dysfunction of the ipsilateral kidney. Interestingly, 29% of patients with unilateral ureteral ectopia had an abnormal contralateral kidney. Only 22 patients (28%) had two normal kidneys, and 5 (6%) had documented renal failure with 2 (2.5%) requiring renal transplant. This compares to a transplant rate of 0.6% among anorectal malformation patients without ectopic ureter. The incidence of ectopic ureter is 3.5% among anorectal malformation patients. Cloaca and recto-bladder neck fistula are the types of anorectal malformation with higher incidence. Ureteral ectopia seems to confer an increased risk of renal failure. Identifying ectopic ureters is important for surgical planning and monitoring renal function vigilantly.

Analysis of HIV testing status and relevant factors in male sexually transmitted diseases patients in Shandong Province

A survey was conducted to analyze the HIV testing status and related influencing factors of male sexually transmitted diseases(STD) patients attending 18 county-level hospitals in Shandong Province from July 2015 to August 2016. The HIV detection rate of 1 570 subjects was 77.58% (1 218/1 570), and the HIV-antibody positive rate was 0.99% (12/1 218). Compared with general hospitals patients, urinary and anorectal patients, non-sexual patients, and patients with negative attitudes toward HIV testing, patients were more likely to be tested for HIV from specialized hospitals (OR=3.74, 95%CI:2.53-5.54), the skin and venereal section (OR=1.92, 95%CI: 1.31-2.79), the STD group (OR=2.02, 95%CI: 1.34-3.03) and patients with positive attitude (OR=15.20, 95%CI:10.74-21.52).

EP-1992 Dose warping protocol for interfraction variation in Bladder filling in ano-rectal cancer patients

EP-1992 Dose warping protocol for interfraction variation in Bladder filling in ano-rectal cancer patients

Correlation of Maternal Age with Prevalence of Chromosomal Anomalies in Patients of Anorectal Malformation

Introduction: Aims: To identify the Anorectal malformations patients in North Indian region and then study the karyotype of these patients to evaluate cytogenetic aberrations and then correlate it with the maternal age. Subjects and Methods: Forty eight patients of anorectal malformation were selected from Department of Paediatric Surgery, KGMU, UP, Lucknow. Blood samples were collected and their cytogenetic study was done in the Department of Anatomy, KGMU-U.P, Lucknow. Karyotypes obtained were further analysed. Results: Out of 48 children enrolled in the study, karyogram could be obtained for 45 cases (93.75%). Maternal age at the time of birth of the child was 30 years of age at the time of birth of the child. However, proportion of those with anomalies was significantly higher in >30 years age group (75%) as compared to that in 30 years of age, which could be due to increased risk of congenital anomalies and malformations with advanced age.

Anorectal melanoma surgical management: A tertiary cancer centre analysis

Background: Primary rectal malignant melanoma is an exceptionally rare neoplasm associated with an extremely poor prognosis despite aggressive treatment. The described management options for localized disease are abdominoperineal resection (APR) and wide local excision (WLE) with or without radiation. Objective: To assess the surgical outcomes of the patients with anorectal melanoma. Design and Setting: Retrospective study. Patients and Methods: This retrospective study describes the experience in surgical management of 18 cases of anorectal melanoma treated surgically at our center, between 2010 and 2015. Main Outcome Measures: To assess the median survival and recurrence rates of anorectal melanoma patients who underwent surgery. Sample size: Eighteen cases. Results: This is a retrospective study of 18 cases of anorectal melanoma. APR was performed in 77.8%, wide excision (WLE) in 16.7%, and posterior exenteration in 5.6%. The median survival of patients undergoing APR was 14.66 months and median survival of patients undergoing WLE was 18 months. No significant difference in median survival was observed in the patients undergoing abdominoperineal resection (APR) or wide local excision (P = 0.168). A significant difference in median survival between the node negative group and node positive group was observed (17 months vs 13.4 months P = 0.019). The median survival of patients with stage I, II, and III cancers were 17.28 months, 16 months, and 13.4 months, respectively. A statistically significant difference in median survival was found between patients with lympho-vascular invasive and noninvasive cancer (13.37 months vs 16.7 months P = 0.029). There was no significant difference in the recurrence rate between APR and WLE groups (86% vs 66% P = 0.893).Conclusion: Anorectal melanoma is an aggressive disease which require timely diagnosis. Nodal status is an important factor that impact median survival. There is no significant difference in survival when WLE compared to APR. Node positivity and lympho-vascular invasion confer poor prognosis. Recurrence rates are identical regardless of the surgical approach. Limitations: It is a retrospective series based on case records. A major drawback of this investigation is the limited detail available for each case. Not all patients who underwent local excision received radiotherapy. Conflict of Interest: None.

The impact of down-regulated SK3 expressions on Hirschsprung disease

BackgroundSome Hirschsprung’s disease (HSCR) patients showed persistent bowel symptoms following an appropriately performed pull-through procedure. The mechanism is presumed to be down-regulated small-conductance calcium-activated potassium channel 3 (SK3) expression in the HSCR ganglionic intestines. We aimed to investigate the SK3 expression’s impact in HSCR patients after a properly performed pull-through surgery in an Indonesian population, a genetically distinct group within Asia.MethodsWe assessed SK3 gene expression in both the ganglionic and aganglionic colon of HSCR patients and controls colon by quantitative real-time polymerase chain reaction (RT-PCR).ResultsWe ascertained fourteen sporadic HSCR patients and six anorectal malformation patients as controls. Quantitative RT-PCR showed that the SK3 expression was significantly lower (23-fold) in the ganglionic colon group compared to the control group (9.9 ± 4.6 vs. 5.4 ± 3.4; p = 0.044). The expression of SK3 in the aganglionic colon group was also significantly lower (43-fold) compared to the control group (10.8 ± 4.4 vs. 5.4 ± 3.4; p = 0.015).ConclusionOur study shows that the down-regulated SK3 expression in ganglionic intestines might contribute to the persistent bowel symptoms following a properly performed pull-through surgery in Indonesian HSCR patients. Furthermore, this study is the first report of SK3 expression in a sample population of Asian ancestry.

Evaluation of Postoperative Headache, Back Pain and Urinary Retention in Benign Anorectal Surgical Patients Under Spinal Anesthesia

Evaluation of Postoperative Headache, Back Pain and Urinary Retention in Benign Anorectal Surgical Patients Under Spinal Anesthesia

Systemic therapy in anorectal melanomas: Does choice of systemic therapy matter?

731 Background: Anorectal melanomas are relatively uncommon and there is no consensus on the optimal systemic therapy regime with survival advantage. Methods: Retrospective analysis of prospectively maintained database of patients treated at our institute between January 2102 and July 2015. SPSS 20 used for statistical analysis. The survival benefit was assessed in the form of progression free survival (PFS) and overall survival (OS) with the systemic therapy. Results: Out of 74 anorectal melanoma patients seen during this period 50 patients had metastatic disease and were evaluated for outcome analysis. Median follow up of patients was 8 months. Of these 50 patients, 36 received chemotherapeutic regimes (taxanes with platinums with or without oral metronomic therapy (OMT), dacarbazine/temozolamide or OMT alone) as per the description of treating physician, while 11 patients did not receive any systemic therapy due to poor general condition at presentation, or refused therapy. 3 patients defaulted during the initial work up. Median age at presentation was 54 years and common sites of metastasis were Liver, lung and lymph nodes. Median OS for patients who underwent excision was 22 months. In patients who received systemic therapy median OS was 13 months versus 8 months for those who did not receive it (p = 0.253). The Median PFS after 1st line systemic therapy was 3 months. 5 patients had grade III toxicities in the form of neutropenia, diarrhea. PFS was 3 months for temozolamide/dacarbazine, OMT along with chemotherapy or OMT alone whereas it was 5 months for taxanes with platinum. (p = 0.045). OS was 11 months for OMT with or without chemotherapy and 18 months for taxanes with platinum (p = 0.43). Conclusions: Palliative systemic therapy has some survival advantage in metastatic anorectal Melanomas. Taxanes with platinums appear to be the most efficacious among the presently used regimens even in anorectal melanomas. OMT also has the survival benefit with the advantage of oral therapy in palliative setting

Clinical effect and nursing care of ultrasonic atomization with traditional Chinese medicine on wound healing after anorectal operation patients

Objective To discuss the clinical effect and appropriate nursing for wound healing after anorectal operation with ultrasonic atomization in traditional Chinese medicine. Methods A clinical research method for random distribution was conducted. Totals of 120 anorectal surgery cases matched with the inclusion criteria were randomly divided into the observation group (TCM group) of 60 cases, and the control group (potassium permanganate group) of 60 cases. The average disappear time of post-operative symptoms were respectively observed and the number of days of wound healing were respectively recorded between the two groups. Results In the observation group, the average disappear time of post-operative symptoms of pain, edema, cataclysm, hematochezia and the healing time were (8.20±1.56), (4.33±0.46), (7.56±1.38), (3.67±1.49) and (14.17±1.58)days, which were significantly shorter than those of the control group (t=4.313, 3.765, 4.983, 3.038, 7.560, respectively; P<0.05). The post-operative healing rate of the 7th and 14th day were (53.66±1.88)% and (89.46±2.13)%, which were significantly higher than those of the control group (t=6.89, 15.08, respectively; P<0.01). In the observation group, 38 cases were significantly effective, 20 cases were effective, and 2 cases had no therapeutic effect, which were significantly better than those of the control group (Z=21.76, P<0.01). Conclusions Fumigation with ultrasonic atomization of traditional Chinese medicine can improve post-operative symptoms and promote wound healing after anorectal operation. Key words: Traditional Chinese medicine (TCM); Ultrasonic therapy; Postoperative complications; Anorectal disease; Atomization fumigation

The effect of implement active nursing intervention in patients with anorectal sur-gery

Objective To analyze the effect of implement active nursing intervention in patients with anorectal surgery .Methods A total of 120 anorectal surgery patients were divided into control and observation groups , 60 cases of each group , patients of control group were given postoperative routine nursing methods and the patients of observation group were given postoperative active nursing intervention , the clinical effect of two groups were analyzed.Results The incidence of dysuria of observation group was （10.00%） and the incidence of bowel problems was （31.67%）, which were obviously lower than those of control group （36.67%, 31.67%）.The incidence of adverse reactions of patients＇posttreatment of observation group （10.00%） was obviously lower than that of control group （40.00%）.The satisfac-tion degree of observation group （90.00%） was better than that of control group （53.33%）, （P〈0.05） .Conclusions Implement ac-tive nursing intervention in patients with anorectal surgery could achieve good clinical effect , reduce the incidence of adverse reactions of pa-tients after treatment , and improve the satisfaction of patients .. Key words: Anorectal surgery Active intervention Effect analysis